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Clinical Factors Associated with Dose of Loop Diuretics After Pediatric Cardiac Surgery: Post Hoc Analysis

Haiberger, Roberta
•
Favia, Isabella
•
Romagnoli, Stefano
altro
Ricci, Zaccaria
2016
  • journal article

Periodico
PEDIATRIC CARDIOLOGY
Abstract
A post hoc analysis of a randomized controlled trial comparing the clinical effects of furosemide and ethacrynic acid was conducted. Infants undergoing cardiac surgery with cardiopulmonary bypass were included in order to explore which clinical factors are associated with diuretic dose in infants with congenital heart disease. Overall, 67 patients with median (interquartile range) age of 48 (13–139) days were enrolled. Median diuretic dose was 0.34 (0.25–0.4) mg/kg/h at the end of postoperative day (POD) 0 and it significantly decreased (p = 0.04) over the following PODs; during this period, the ratio between urine output and diuretic dose increased significantly (p = 0.04). Age (r -0.26, p = 0.02), weight (r -0.28, p = 0.01), cross-clamp time (r 0.27, p = 0.03), administration of ethacrynic acid (OR 0.01, p = 0.03), and, at the end of POD0, creatinine levels (r 0.3, p = 0.009), renal near-infrared spectroscopy saturation (-0.44, p = 0.008), whole-blood neutrophil gelatinase associated lipocalin levels (r 0.30, p = 0.01), pH (r -0.26, p = 0.02), urinary volume (r -0.2755, p = 0.03), and fluid balance (r 0.2577, p = 0.0266) showed a significant association with diuretic dose. At multivariable logistic regression cross-clamp time (OR 1.007, p = 0.04), use of ethacrynic acid (OR 0.2, p = 0.01) and blood pH at the end of POD0 (OR 0.0001, p = 0.03) was independently associated with diuretic dose. Early resistance to loop diuretics continuous infusion is evident in post-cardiac surgery infants: Higher doses are administered to patients with lower urinary output. Independently associated variables with diuretic dose in our population appeared to be cross-clamping time, the administration of ethacrynic acid, and blood pH.
DOI
10.1007/s00246-016-1367-x
WOS
WOS:000377722400014
SCOPUS
2-s2.0-84960085303
Archivio
http://hdl.handle.net/11390/1085699
Diritti
closed access
Soggetti
  • Acute kidney injury

  • Cardiopulmonary bypas...

  • Fluid balance

  • Loop diuretics

  • Metabolic alkalosis

  • Pediatric cardiac sur...

  • Cardiology and Cardio...

  • Pediatrics, Perinatol...

Web of Science© citazioni
4
Data di acquisizione
Jun 8, 2022
Scopus© citazioni
3
Data di acquisizione
Jun 7, 2022
Vedi dettagli
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